Provider First Line Business Practice Location Address:
3717 HUCKLEBERRY ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18104-9354
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-351-7221
Provider Business Practice Location Address Fax Number:
610-351-6827
Provider Enumeration Date:
04/24/2008